This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Thursday, March 31, 2016

The Macro View - General And Health News Relevant To E-Health And Health In General.

March 31 Edition

The macroeconomic stresses seem to have eased a little more with markets rising around the world. Indeed the stock market indices in the US are flat for the calendar year.

In Australia, things are also looking up for the present, although the long weekend has slowed improvement down.

With Budget Night now May 3 we won’t have long to wait to see what is happening. Tax cuts and superannuation changes seem to be the favoured outcomes.

Here is a summary of interesting things up until the end of last week:

Prime Minister Malcolm Turnbull has announced he will bring the budget forward a week, setting the scene for a rare double dissolution election on July 2 unless the Senate passes laws to reintroduce the construction industry watchdog.

In a snap press conference at Parliament House on Monday, Mr Turnbull said he had received permission from Governor-General Sir Peter Cosgrove to recall both houses of Parliament on April 18. The government will try to pass a bill restoring the Australian Building and Construction Commission and a separate bill, already rejected twice by the Senate, toughening standards for union governance.

If the government's bills are not passed, Mr Turnbull will call a double dissolution election - the first since 1987.

Sydney Morning Herald political and international editor

Interest rate policy and the price of iron ore are two of five key factors, which can determine the rise and fall of the Australian dollar.

Ken Courtis went to the bank on Saturday. He wanted to withdraw some cash. Nothing unusual so far.

But this was Japan, and Japan is a pioneer in passing through the looking glass into the weird world of negative interest rates. So instead of paying Courtis interest on his money, his bank did the opposite. It extracted interest from him. When he took 50,000 yen – about $600 – the bank charged him 1 per cent interest. It also took a further quarter of a per cent as a processing fee.

"I refused to pay both," relates Courtis. It wasn't that he didn't understand the concept of negative interest rates. It was simply that the economist, former Goldman Sachs dealmaker and long-time Tokyo resident didn't want to pay.

Australia's self-managed super fund sector continues to break records even as trustees brace themselves for potential wide-ranging legislative changes in the next budget.

The SMSF sector surged 2.7 per cent in the December quarter to a record $594.6 billion across 566,735 funds, according to Australian Taxation Office data.

SMSFs account for almost one-third of the approximate $2 trillion retirement system and, while typically catering to older and wealthier Australians, the sector is also now attracting an increasing number of younger investors.

Australia has ample firepower to deal with any coming shock to the economy by lowering interest rates or loosening fiscal policy, the country’s central bank said Tuesday.

“Even with interest rates at already low levels, and public debt higher than it was, there would, in the event of a serious economic downturn, be more room to ease both monetary and fiscal policy than in many, indeed most, other countries,” Reserve Bank of Australia Governor Glenn Stevens said in speech notes prepared for a Sydney conference.

The remarks come as Treasurer Scott Morrison prepares to deliver his first budget on May 3 against a backdrop of growing uncertainty globally, downgrades to growth forecasts, and significant volatility in global equities markets and commodity prices.

Rating agencies have said that Australia may lose its coveted AAA-sovereign rating if the government does not spell out a path back to budget surpluses.

Just 3 per cent of voters think a company tax cut should be the government's top economic priority, according to a devastating poll that will put further pressure on the Coalition's pre-budget planning.

Treasurer Scott Morrison has indicated company tax cuts are on the agenda for the May 3 budget - rather than income tax relief - arguing the best way to drive economic growth was by reducing the tax paid by employers.

But the public is far less keen on that prospect, much preferring budget repair, education spending or personal income tax cuts to take top billing on the government's economic agenda.

New rules to dictate when doctors should refer patients for expensive tests and scans may be a year away but experts say they will be crucial to managing the health budget and promoting evidence-based care.

The federal government’s review of 5700 items on the Medicare Benefits Schedule is gaining momentum, with another 25 committees and working groups — involving more than 500 clinicians — to be engaged this year.

The review arose from the failed GP co-payment and comes as health groups warn that cost-cutting will lead patients to avoid medical attention rather than seek the most appropriate care.

Of the first six MBS committees at work, recommendations are expected within months in the specialties of ear, nose and throat surgery, obstetrics, thoracic medicine and gastroenterology.

Environment Editor, The Sydney Morning Herald

Australia's top medical research body has given two researchers $3.3 million to study the effects of wind farms on human health despite its own year-long study finding no "consistent evidence" that a problem exists.

The National Health and Medical Research Council (NHMRC) awarded Guy Marks, a professor at the University of NSW $1.94m, to study the health impacts of infrasound - sound waves typically inaudible to humans - generated by wind turbines.

"Existing research in this area is of poor quality and targeted funding is warranted to support high quality, independent research on this issue," Anne Kelso, NHMRC's chief executive, said in a statement.

Hospitals don’t need increased funding, they need to make better use of what they’ve got

The Australian hospital sector is facing growing pressure, not least around funding. The states are struggling to come up with the funds to fill the gap left by the Commonwealth’s 2014 budget announcement that it will reduce the levels of federal hospital funding from next year.

Australia’s health system is a network of service providers, rather than a single, coherent system. The rules around funding and access – even within a single hospital – are often different, making it difficult for patients to navigate their health-care journey.

Another feature of a system with multiple interfaces between services is queues. Australian patients do an awful lot of waiting. It’s not just inconvenient to the patient, it can result in increased cost of care and reduced health outcomes.

Proposed solutions usually focus on the need for more resources, be it money, beds or staff. But fixing the hospital system is not just a matter of more and more funds. We don’t necessarily need to increase funding to the public hospital system, we need to make better use of what we’ve got. Hospitals need to work smarter, not harder.

Malcolm Turnbull and Scott Morrison are struggling to decide a $1 billion health deal that will be central to a July 2 election ­campaign in another sign of their personal tensions, as Labor exploits the divisions to warn of ­“dysfunction” at the top of the ­government.

The Prime Minister and Treasurer are at odds over spending plans that will put hospital funding at the heart of the campaign, amid fears of incendiary attacks from the states over emergency ward cuts that could put lives at risk.

State officials were told last ­Friday that Mr Turnbull was “fighting” for a better funding deal on hospitals and early childhood education but key ministers were opposing the aid ahead of a federal budget that will set out long-term savings to help pay for tax relief.

Stop-start funding is sabotaging Australia’s chances of leading a field poised to transform medicine, the Australian Academy of Science has warned.

A think tank convened by the academy says stem cell science needs to be declared a ­national research priority to help realise its promise. “That support cannot be provided by the current mechanisms of small individual grants,” said Richard Harvey, who helped lead the forum last year.

“Every country with a laboratory is engaged in stem cell research, from Iran to India, China, Russia and Korea. We have a competitive situation where we need to think strategically how we’re going to support this area of science over the next five to 10 years.”

Legal affairs, health and science reporter

Labor is launching its pre-election attack on the Coalition's health record in Prime Minister Malcolm Turnbull's electorate, where a health clinic for homeless people is set to close.

Deputy Opposition Leader Tanya Plibersek will use a press conference at the Haymarket Foundation Clinic in Darlinghurst to highlight what Labor says is the Abbott government's $60 billion cuts to health over the next decade in 2014, and the Turnbull government's planned cuts to bulk-billing incentives for pathology and diagnostic imaging services.

Health Minister Sussan Ley has defended the government's move to save $650 million over four years by cutting the incentives, saying they had not worked to significantly boost the rate of bulk-billing.

THE largest and most profitable health insurer wants to hit people as young as 26 with a decade-long penalty for not taking out private cover.

But fund members want the opposite — a chance for anyone who doesn’t hold a policy to be able to join the system without paying Lifetime Health Cover loading, which adds as much as 70 per cent to premiums.

Nearly two-thirds of 45,000 policyholders surveyed as part of the Big Health Insurance Switch say they support a Lifetime Health Cover loading amnesty. Less than seven per cent are against a moratorium. The rest are unsure.

Reporter

Comparison website iSelect has hit back at the Australian Medical Association for its attack on comparators in its inaugural health insurance report, saying the real pressure on consumers comes from the soaring cost of healthcare.

In its report last week the AMA, which lobbies on behalf of doctors, singled out for-profit health insurance comparators like iSelect as a serious concern. The AMA questioned both the independence of policy recommendations on such websites and the influence of commissions from the health funds.

iSelect chief executive Scott Wilson said that contrary to the AMA's assertions, commissions do not influence policy recommendations and do not increase the overall cost of health insurance.

"Our sale prices are not influenced by our commissions. The individual [iSelect sales] adviser does not know what the commissions are from individual funds," he said.

Consumer Affairs Editor

Medibank and NIB offer some of the worst of the "junk" health insurance policies on the market, providing little more than what is already offered under the universal healthcare scheme Medicare, say consumer advocates.

As the federal government reviews the $19 billion private health insurance sector, leading consumer group Choice has rated Medibank's 'Young Hospital' and 'Accident Only' covers as "effectively useless" and likely to leave customers in the lurch.

"Our analysis shows that in many cases, junk policies cover less than one per cent of the services available in hospital, and exclude treatment for the most common serious illnesses such as cancer, stroke and heart disease," said Choice's Tom Godfrey.

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Health is also clearly still under review as far as its budget is concerned with still a few reviews underway and some changes in key strategic directions. Lots to keep up with here with all the various pre-budget kites still being flown - although narrowing it seems to be largely focussed on Super! Enjoy.